Permit application for work at 143 Fulton Street, undated

NYC 9/11 Public Portal Document U x oak OY FPA, NYC DEPARTMENT OF ENVIRONMENTAL, PROTECTION P / | Fi 3 ‘Somme i Asbestos Control Program SS © D=P . * 59-17 Junction Boulevard, 8” Floor, Corona, NY 11368-5107 ag _ RITTEN "mg, NS MS WIL BE “MO (ASBESTOS INSPECTION REPORT) MM AIS ZOvi een Bullding Dept. or TRU Nd FOR OFFICIAL USE ONLY * ASBESTOS PROJECT NOTIFICATION CEPTED (See fee schedule) AS When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with original signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. This form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities . I. FACILITY 2. Address __143 FULTON SreeeT Borough ___MAN Zip__ 10038 AKA 3.Block 82 4. Lot __B 5. Type of Facility ComMMER CIAL. 6. Name of Building et fl. BUILDING OWNER ‘ ee 7.Name 145 Four Ann ___INe. - ‘ 8, Contact Person_Nicw Vegos 9. Tel. # (21297134- OSCO _Fax# CUB) 134-4IS | 10. Address_4 EAST GOTH STREET city New Yor. State_ WY Zip 1002) ill. GENERAL CONTRACTOR 11. Name Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR 12. Name BENJAMIN, Koez@an © Sens Copreot {ne 13. Contact Person Lowe lANNico 14, Federal Employer ID. # Pll i___.. 15, Tel. # CUE) $B1-2900 Fax# (tis) 209-1808 16. Address '248 RACPR AVENUE City __Beooviwin State NY Zip _UN236 V. THIRD PARTY AIR MONITOR 17.Name Wareeem 1 Panzer Enaqmweees 18. Contact Person__Miestaet Notas 49. Federal Employer ID. #! Pil | 90. Tel. # (212) 922- SCOTT Fax# C212) 922-06 SO 21. Address 226 EAst 45m Sweet City__ Nes Yoe State NY Zip _iOO!'T 22. Sample Analysis Laboratory 23. NYS DOH ELAP # Vi. PROJECT INFORMATION 24. Starting date for this portion of work __ 2 lseloz, Projected completion date _{ olsoloz Asbestos work schedule Monday A Tuesday Wednesday 4 Thursday Friday Pas Saturday Sunday eo Shift from: _. ee am CI pm to = 1] am Kl pm If other, specify Access to inspect the premises must be provided during the work schedule indicated in this item. 25. Total amount of asbestos-containing material to be abated during this work Fa 14012: ‘Square Feet, and/or © __ Linear Feet NYC-WTC_000128042